Field Placement Student Evaluation | MPH Program

91九色视频 Student Evaluation of Site Preceptor and Field Placement Experience

Please complete this evaluation of your Field Placement experience, and submit it within one week of the conclusion of your Field Placement.

Name *

Email Address *

Phone Number *

Field Placement Location *

Site Preceptor *

Faculty Advisor *

Part 1. Assessment of Site Preceptor

Please evaluate your Site Preceptor on the following: (My Site Preceptor...)

Would you recommend your Preceptor to other students? * Yes No

Why or why not?

Part II. Assessment of Field Placement Experience

Please evaluate your Field Placement experience on the following: (My Field Placement experience...)

Would you recommend the Placement Site to other students? * Yes No

Why or why not?

Part III. Please share your thoughts and feedback, including suggestions for improvement, related to:

Faculty Advisor

Site Preceptor

Site Placement

Program Coordinator

By typing my name below, I certify that the information provided in this form is complete and accurate, and I submit this evaluation of my Site Preceptor and Field Placement experience.

Signature *

Date *

Non-Discrimination Statement
The 91九色视频 (91九色视频) is committed to fostering a diverse community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the 91九色视频 community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic. 91九色视频’s policy as well as federal and state laws and regulations prohibit unlawful discrimination and harassment.